Long-term use of bisphosphonates (BPs) has been associated with a specific type of tensile side femoral stress fracture known as Atypical Femoral Fracture (AFF). Theoretically periprosthetic femoral fractures (PFF) should be excluded from the diagnosis of AFF. However, emerging evidence correlates prolonged BPs use with the occurrence of a type of PFF with an atypical pattern (atypical PFF, APFF). The aim of the present study is to report 3 cases of APFF treated at a single centre.
Clinical and radiographic records of PFF that occurred between January 2016 and August 2018 were retrospectively reviewed. All patients meeting the American Society for Bone and Mineral Research (ASBMR) criteria for definition of PFF were included. Management strategies for APFF and patient outcomes, including fracture healing and hip function (assessed by the Oxford Hip Score [OHS]) were collected.
3 patients in the study period were identified as APFF (1 incomplete, 2 complete). All patients were females with a mean age of 83.3?years. All patients were treated with lateral plating. The application of a contralateral strut allograft resulted in fracture healing in cases of complete fractures. Mean OHS at final follow-up was 34.3.
Despite occurring around a hip stem like PFF, APFF had peculiar clinical and radiographic features, making them more similar to AFF. Therefore, the orthopaedic surgeon should also consider the natural history and healing problems associated with AFF prior in order to choose the most appropriate management for APFF.
Despite occurring around a hip stem like PFF, APFF had peculiar clinical and radiographic features, making them more similar to AFF. Therefore, the orthopaedic surgeon should also consider the natural history and healing problems associated with AFF prior in order to choose the most appropriate management for APFF.Periprosthetic fractures (PFs) are a main complication after total hip arthroplasty (THA), with rising incidence. The optimal treatment of PFs is still being debated in the literature. Historically, high failure and reoperation rates are reported, although the introduction of locking plates has led to improved results. In this study we report clinical and radiographic outcomes of a consecutive series of Vancouver B1 and C fractures, treated with a novel type of locking plate. We also aim to identify the variables associated with healing time.
Between June 2013 and May 2019, 47 patients were consecutively admitted to the Emergency Department of our Hospital with a diagnosis of PF around a well-fixed THA stem. 31 patients fulfilled the inclusion criteria and were included in the study. https://www.selleckchem.com/products/glycochenodeoxycholic-acid.html All patients underwent osteosynthesis with a novel type of plate ("Ironlady" Intrauma, Rivoli, Italy) through a distally extended posterolateral approach. All surgical procedures were performed with the aim of reducing the riender.
On the base of our results, the management of Vancouver B1 and C type of PFs by locking plate osteosynthesis appears to be a safe and effective procedure. To enhance healing and reduce complication rate, accurate surgical technique is required, aiming to implement the proximal fixation, avoid stress rising, reduce rigidity of the osteosynthesis construct and preserve the plate-to-bone gap.
On the base of our results, the management of Vancouver B1 and C type of PFs by locking plate osteosynthesis appears to be a safe and effective procedure. To enhance healing and reduce complication rate, accurate surgical technique is required, aiming to implement the proximal fixation, avoid stress rising, reduce rigidity of the osteosynthesis construct and preserve the plate-to-bone gap.Instability and dislocation after total hip arthroplasty (THA) is a common reason for revision surgery. THA head-neck adapters promise the reconstruction of optimal femoral offset and leg length in revision THA (rTHA) while retaining stable implants. The aim of this retrospective multi-centre study is to report on the results achieved with the use of head adapters in partial rTHA, to avoid the instability of the implant.
55 cases of partial rTHA performed between February 2015 and April 2017 in 3 different hospitals using the Bioball Head Adapter (BHA) (Bioball Merete, Medical GmbH, Berlin, Germany) were retrospectively recorded. All patients were evaluated from a radiological point of view at an average follow-up of 3.5?years. Failure was defined as re-revision surgery for any cause as well as a subjective feeling of instability of the joint.
One failure was registered in an extreme case and radiological findings show no suggestive signs of radiolucencies or loosening and therefore all implants have been considered stable.
Despite some limitations of this retrospective study and according to the relevant literature, our data confirms that BHA is a safe system that allows the flexibility to restore femoral offset and version, to adjust leg length, to minimise instability, to avoid unnecessary removal of otherwise well-fixed components thus improving tribology and reducing the risk of taper junction issues without major complications in partial rTHA.
Despite some limitations of this retrospective study and according to the relevant literature, our data confirms that BHA is a safe system that allows the flexibility to restore femoral offset and version, to adjust leg length, to minimise instability, to avoid unnecessary removal of otherwise well-fixed components thus improving tribology and reducing the risk of taper junction issues without major complications in partial rTHA.Macduff Marine Aquarium is a native species aquarium situated on the Moray Firth coastline and houses the curled octopus, Eledone cirrhosa, for public display. Historically, the designated octopus display tank has been in-keeping with the overall theme of the aquarium, consisting of artificially created rock work mimicking the local rocky coastline, within an angular glass tank. This tank was not originally designed for housing octopus and as a consequence, if individuals on display exhibited jetting behavior mantle abrasion occurred. In 2016, a new bespoke octopus tank was designed and installed. Since then 14 different octopuses have been individually housed and maintained within the tank, with none having experienced mantle abrasion. This paper highlights the importance of aquarium design for the ethical maintenance of an intelligent and challenging species.